Counselling Priorities in China and the United States: A Cross-Cultural Review of Identity, Stigma, and Help-Seeking

Abstract

This study critically reviews differences in counselling priorities between China and the United States in relation to broader cultural contexts. It argues that although counselling in both societies ultimately aims to promote psychological well-being, culturally salient counselling concerns differ across settings. In U.S. counselling literature, multicultural competence, intersectionality, cultural humility, race, ethnicity, religion/spirituality, gender, sexuality, and discrimination are frequently foregrounded in relation to therapeutic trust and alliance. In contrast, Chinese counselling literature more commonly emphasises stigma, self-reliance, low mental health literacy, face concerns, family expectations, social pressure, and reluctance to seek professional help. These differences should not be interpreted as rigid national oppositions; rather, the review suggests that both contexts involve issues of identity, stigma, access, and trust, albeit expressed in culturally distinct ways. The paper concludes by arguing that culturally responsive counselling should move beyond essentialised East–West binaries and instead address locally situated experiences of identity, stigma, trust, and social responsibility.